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Comment by earthtourist | Hacker News Reader

We could conceivably stop the spread in the US: Cancel school, declare a national quarantine, provide temporary basic income to workers without WFH ability, start mass testing, deploy the military, and more.

It would require very drastic measures but would undoubtedly save a huge number of lives. Amazingly, leaders in all democratic countries seem to be too cowardly, too dumb, or too short-sighted to take the action required.

They want to exchange lives for money. And it might not even be a good trade. Letting 70% of a country get infected, even over time, might end up costing more lives and more money.

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I get what you're saying, but realize many people will go without wages in these scenarios, so that has to be accounted for. Also, I've seen experts warn that however long things are shut down, once this is ended, the spread will continue. There's no conceivable span of time things will be "shut down" such that the disease will completely stop spreading.

All this to say, yes, of course shut downs must occur to stop acute problems in healthcare systems and try best to protect elderly. And this should absolutely be prioritized over financial markets (though risks here still matter). But it is going to spread.

Counterargument: China

So when China removes all quarantines, what is going to stop the virus from spreading once again? It will spread (of course at a reduced rate since there is some immunity) until one of the following scenarios occurs:

- Virus has exhausted itself with the majority of the population. - Vaccine is developed and universally available. - Virus is eradicated from quarantine (so incredibly unlikely).

I am not an epidemiologist, just writing based off of common sense.

A series of staged quarantines, combined with mass testing, should be able to keep it contained until a vaccine is (hopefully) ready in 18 months.

There's really no great alternative to attempting to contain it. We will most likely trade lives for money and then lose the money anyway. Better to just lose the money by paying a big price early on with a radical containment strategy.

> what is going to stop the virus from spreading once again?

If the quarantines last long enough, the virus will be dead. The hosts will either be dead or will have successfully fought the infection and destroyed the virus. Unless it happens to behave like some viruses that can hide in the nervous system and similar – but there's no indication that that's the case.

> "...deploy the military...save a huge number of lives..."

really, that's the best solution to saving lives?

if you were really worried about preventable deaths, why don't you direct your fear-mongering and authoritarianism toward eradicating distracted driving, since car accidents kill a million people a year?

otherwise, wash your hands and keep a little distance from coughers/sneezers. if you get sick with (1) a high fever and (2) a dry cough, don't go out for 14 days after you feel better, unless you're so sick you need to go see a doctor.

that's it. stop with the hysteria.

Your proposed alternative is woefully inadequate and doesn't stop the exponential spread of the disease anytime short of most people getting it.

You flat out do need to shut down most things to get the spread rate below 1.0. Cancel all gatherings of people, shut down non-essential businesses, etc. That's all that works.

that's presuming the need to stop the virus at all costs. if we were dealing with the black plague, or even the 1918 flu, that would be entirely reasonable. but with covid-19, that's still debatable, especially given the costs of doing so.

we're apparently collectively ok with 30K americans dying of flu (or alternatively, auto accidents) every year, so it doesn't make sense to go nuts on stopping this virus that's looking more and more like it's a little worse than the yearly flu.

the point being risks need to be properly assessed and proportionately addressed, without hysteria.

the underlying question about whether we value human lives enough is another matter we certainly should continue to discuss (for the record, i think we should value human lives a little more relative to economic considerations, and the response to something like covid-19 would correspondingly be a little more proactive, but still not hasty and panicked).

"this virus that's looking more and more like it's a little worse than the yearly flu."

You're spreading ignorance.

Every medical expert is saying it is 5-20x deadlier than the seasonal flu, because that's what the data says. They're predicting 40-70% infection rates.

A low estimate of 0.05% mortality rate with 40% infected is: 640,000 dead in the US alone. It could end up being a 1.5% mortality rate with 70% infected: 3,360,000 dead in the US alone.

Please do some reading: https://www.flattenthecurve.com

It would likely be >1% mortality rate even with adequate healthcare. If it hit 40-70% of the population though, people would be basically on their own, so mortality rate would be 5-10%. Tens of millions of deaths.

Of course, this would never happen, since we as a society would enact major policies to slow the spread long before it got anywhere near that bad, just as Italy is doing for example. It just doesn't make any sense to wait for things to get worse to start enacting policies to slow its spread; if we're going to have to do it at some point, might as well do it early and reduce the spread.

70% of the country will get infected. No matter what we do. The only difference is how long it will take. Even with the most drastic measures imaginable, 70% will get infected. If they all get infected in the next month, the death rate skyrockets. If it takes 6-12 months, the death rate will be ~0.5%. Heck, we might even have reliable clinical results indicating a useful treatment by then. Right now on that front all we have is a very small amount of anecdata, but we should expect some decent data on Remdesivir from China soon, and I guarantee you that every pharma/biotech in the world with a nucleotide analogue is doing testing/screening today.

> 70% of the country will get infected. No matter what we do.

That's not really true. South Korea and China have proven that this thing can be stopped and R0 can be driven below 1. It just requires decisive action by the state (either heavy quarantining or mass testing coupled with behavioral changes by the population).

Stopped has not been proven anywhere. Maybe my conviction was a little too strongly worded, but we shall learn in a few years via serological testing regardless. My guess is that when final numbers come out we will find that about 50-70% of the global people are seropositive (meaning they have been exposed). That's about what we get for most endemic viruses. Check back in a few years and we shall see.

Let me put it this way: symptomatic cases as a percent of the population in China and South Korea are multiple orders of magnitude lower than what we saw on the cruise ship, and the growth of cases testing positive (or showing symptoms) is slowing (in absolute not just relative terms).

Rather than calling out the troops, who after all are also humans who can spread disease, why not think about money the government could spend in less destructive ways? They could pass a law that allowed CDC to designate particular counties "at-risk" for particular periods. Any resident of such counties whose cell phone records document that she or he didn't leave her or his home for a whole week during the period could get paid say $1000 tax-free for that week. Sure, it wouldn't be 100% effective, but it would be more effective and probably cheaper in the long run than violent national guard police actions.

It might, but if the measures are drastic enough people will start shooting. (Please don't construe that as an endorsement or advocacy; it's a comment on the complex socio-political mores in the USA.) Pick your poison.

How do you feed the people in your scenario? Many don't have more than a few days of food in-house, if that.

This scenario does not shut down grocery stores, and allows you out of the home in scheduled slots solely for the purposes of going to a grocery store or pharmacy/doctor/hospital. All other trips are banned. This is what China and Italy are doing.

There is no country on Earth that is gonna lock up all its citizens indoors and starve them to death. Governments aren't that stupid.

So you can absolutely "stop" the spread with an absolute quarantine. I don't think you can absolutely "stop" the spread if everyone is using enough infrastructure to go register for a brand new basic income program that might work better than say, public options for healthcare, or alternately keep going to work, if they keep going to the grocery store, including any public transportation required, keep working at required services like fire, police, medical, etc. and if they keep doing any number of other essential things we're forgetting here.

And were there not videos of government agents welding bars on windows and destroying food to punish quarantine breakers recently?

I think you're dramatically oversimplifying how this all works.

Let me tell you how the grocery stores in Italy are operating (I have relatives there):

First of all, you have to schedule a specific time slot to go shopping, to ensure that the store never gets too crowded. Secondly, you aren't allowed within two meters of anyone at any point. All of the store employees are wearing protective gear (gloves, masks, etc.). When you checkout, you push your cart up to them, they ring everything up, set it back down, and then you pack your bags yourself while they go away (to maintain a distance of two meters). They might be changing gloves with every checkout, too.

I have less knowledge of China, but I think it's similar. I saw a video of a ranged thermometer being used on every person before being allowed inside. Maybe Italy is doing similar. If and only if you have a fever or a confirmed infection then are you not allowed to leave your dwelling at all (unless it's to go to a hospital); that's when you get your food delivered.

With containment measures this drastic, you can definitely keep the infection rate below 1, which is all you need to stop an infection. And it's exactly these kinds of measures that need to be taken, because food is essential. You cannot have people starving to death en masse. Grocery stores are essential, and it's possible to allow grocery shipping while largely mitigating the spread of disease. Needless to say, all gatherings are banned, most stores are shut, and restaurants are to-go/delivery only (if they're even still open).

And I'm not drastically over-simplifying things, unless you somehow think that "shut down almost everything except for grocery stores and healthcare" is "over-simplified". This is working in China. They are stopping the spread of the disease while simultaneously maintaining access to food and healthcare.

Italy is already working on doing exactly that. They've closed everything except the food stores -- most of which are running out of food with no prospects towards resupply, since roads are closed and workers aren't permitted to work at the plants that are necessary parts of the food supply chain.

What I heard is that roads have checkpoints on them, but aren't closed for necessary trips, which would include food transport. A solo operator of a vehicle driving food to a warehouse or grocery store isn't a big infection risk, especially with appropriate precautions being taken like social distancing, wearing masks, washing hands frequently, etc.

The food production aspect though is more problematic; it can involved larger groups of people and more human contact.

Yeah, there may be one more delivery to the typical store before the end, but without workers, warehouses will empty, and without an economy, generally everything will collapse.

Economies aren't just playthings for little pieces of multicolored paper -- they're the process by which we live a life different from that of a wild animal.

Life without an economy would be smelly, brutal, and short.

Personally, I pray that the US won't try this idiocy, and further pray that people won't stand for it if they try.

I don't think it'll get that bad in Italy. It wouldn't make sense to allow that to happen, as the cure would be worse than the disease. China has managed somehow.

There is no way to know what actually happened in China, due the way they control information.

Come on. This is not true.

The whole supply chain is guaranteed (and related companies allowed to work).

Source: I'm italian and directly affected by this

Some first hand detail would be greatly appreciated.

> Many don't have more than a few days of food in-house

At this point if you don't have at least a week's supply of rice on hand you're just being careless. It's dirt cheap and large sacks are readily available everywhere.

Which still leaves the toilet paper problem unsolved, all the rice needs to go somewhere!

But in all seriousness, general guidelines are already that, even without stuff like Corona or not.

One advice from the supply chain perspective, so. If you have to stock up, do so in small quantities across multiple stores. reducing the number of stock-outs at the point-of-sale has an unbelievable efeect in stabilizing supply chains. and the last thing we want is unstable supply chains right now. As rediculous as it is, if something like th toilet paper scare happens to more life-ciritical stuff things turn a lot less funny rather quickly.

If the water keeps running, no toilet paper isn't a real problem. If the water stops running, you've bigger problems.

This is so laughable.

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